Veterans Access to Direct Primary Care Act

VA budget: Lobbied for Congress to provide funding to plug a $15 billion budget shortfall for FY 2024 and FY 2025. Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied on the specialization of claims processing for highly complex cases. Lobbied to prevent compassion fatigue for certain claims processors. Lobbied for reforms to the VBA National Work Queue. Lobbied for oversight and improvements into VBA employee training. Lobbied on VBAs use of Performance Improvement Plans. Board of Veterans Appeals: Lobbied for the introduction and in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act including the re-instatement of GS-14 career ladder position and the career path to a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R. 1378, the Veterans Appeals Backlog Improvement Act. Lobbied for additional oversight at the Board of Veterans Appeals. Lobbied for additional training for Board of Veterans Appeals Attorneys. Lobbied in support of ANS to H.R. 1530, the Veterans Benefits Improvement Act of 2023. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Collective Bargaining Rights: Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied in support of H.R. 6538, the VA Correct Compensation Act of 2023 and for its introduction in the Senate. Lobbied in support of S. 4046/H.R. 9855, the "VA Employee Fairness Act. Lobbied in support of and for changes to S. 2679, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. HR modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 7127/S. 3688, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 and 2025 VA Military Construction appropriations bill. VA Quality: Lobbied to amend H.R. 6330, the Veterans Sentinel Act to include data collection and analysis for suicides that happen when veterans are served at non-VA facilities. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied against an amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would codify Trump-Era access standards responsible for rapid privatization of the VA, prohibit VA from modifying access standards to allow telehealth to satisfy these access standards and require VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against a proposal to create a pilot program under which the Secretary would contract out to fill vacancies at a medical facility with non-department health care providers. Lobbied against a provision in H.R. 9438, the No Wrong Door for Veterans Act, reduces the wait time for VA mental health care from the current 20 day to just 3 days. Lobbied in opposition to H.R. 9146, Ensuring Continuity in Veterans Health Act, which would require the Secretary to include continuity of care as one of the criteria used to determine when private care would be in the best medical interest (BMI) of a veteran undermining VAs ability to decide when returning a veteran to the VA is the in the best interest of the veteran. Lobbied against the Veterans Mental Health Access Act, which would create a parallel private mental health program that supplants VAs direct care system rather than supplement it when veterans cannot reasonably access VA care. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act, which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied for oversight of new VA private contracting program, the Integrated Critical Staffing Program. Lobbied for oversight of VA staffing reductions. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters. Lobbied for better information on scheduling and appointment times for both in-house VA and private care. Lobbied for more information about the costs of VA care. Lobbied against VA raising the ceiling for payment to third party private, Community Care contractors. Lobbied against prohibiting public health care programs from using QALYs to determine price. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act, and urge that it be defeated on the House floor. H.R. 485 would increase already high healthcare costs for the Federal Employees Health Benefits Program (FEHBP), which covers the vast majority of AFGE members and their families. In additional to FEHBP, the bill would prohibit Medicaid, Medicare Advantage (MA) plans, Medicare Part D Plans (PDPs), the VA, and the Defense Health Agency from using Quality Adjusted Life Years (QALYs) - a measure that ascertains the value of a drug - to make decisions about a drugs price. Medicare already prohibits the use of QALYs in ways that discriminate against the elderly (such as by valuing the extension of life of an older person as less than extending the life of a younger person). Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would: 1) codify Trump-Era access standards responsible for rapid privatization of the VA, prohibits VA from modifying access standards to allow telehealth to satisfy these access standards and requires VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations and 2) require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against Amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services that would not apply to private RRTP facilities, promoting privatization. Lobbied against provisions in H.R. 8371, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act that would allow decisions between a veteran and a doctor to remain final without VA authorization and provisions that would require strict timeframes for placement of high-risk veterans in mental health treatment programs for VA programs but not private programs. Lobbied in support of final passage of S. 141, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. Statements and Correspondence: Testified before the House Veterans Affairs Subcommittee on Health on December 17, 2024 legislative hearing. Specific Legislation: Lobbied in support of H.R. 6538, the "VA Correct Compensation Act of 2023." Lobbied in support of S. 4046/H.R. 9855, the VA Employee Fairness Act. Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure, and certification reimbursement, covid leave flexibility, and recruitment and retention at VA community living centers. Also lobbied for specific changes to the bill related to the inclusion of VA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S. 2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support and for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied in opposition to S. 2649, the Making Community Care Work for Veterans Act. Lobbied in opposition to S. 1315, the HEALTH Act. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Act, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse‐ patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied in opposition to H.R. 3176, Veterans Health Care Freedom Act, which creates a three-year pilot program allowing veterans to obtain hospital care, medical services, psychological services, and extended care bypassing VA authorization and the need to meet access standards. Lobbied in opposition to H.R.5287, the Veterans Access to Direct Primary Care Act, would establish Health Savings Accounts (HSAs) funded by the VA that veterans could use for private healthcare. Veterans electing these HSAs would be completely barred from accessing VA healthcare services. Lobbied in opposition to the Complete the Mission Act (No bill number). This proposal codifies the Community Care access standards, modifies 38 USC 1703(d)(2) to make veteran preference to go to a private provider a criterion for what constitutes best medical interest and creates a pilot three-year pilot program in at least five locations where veterans could access outpatient mental health and substance use services. AFGE opposes this provision as it would circumvent VAs ability to coordinate care and is unsustainable for the VA in the long term. Lobbied to preserve changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act Lobbied for the introduction and support of the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act. Lobbied for changes to H.R. 7793 the Veterans Appeals Operations Expansion Act of 2024; Lobbied for changes to H.R. 7917, the Veterans Appeals Efficiency Act of 2024; Lobbied for changes to H.R. 7919, the Veterans Claims Quality Improvement Act of 2024. Lobbied or changes to H.R. 7883, the Toxic Exposures Examination Improvement Act Lobbied in opposition to H.R. 7734 the Personnel Integrity in Veterans Affairs Act of 2024 Lobbied in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act Lobbied in support of H.R. 2971, the Veterans Claims Education Act of 2023 Lobbied for changes to H.R. 8874, the Modernizing All Veterans and Survivors Claims Processing Act Lobbied in support of and for changes to H.R. 8879, the Improving VA Training for Military Sexual Trauma Claims Act Lobbied for changes to H.R. 8881, the Rural Veterans Improved Access to Benefits Act of 2024. Lobbied for passage of H.R. 9747, the Continuing Appropriations and Extensions Act, 2025 to continue to fund the federal government through December 20, 2024. Lobbied in support of final passage of S. 141, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. Lobbied against expanding use of Schedule F for VA employees.

Client expense: $570,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Department of Veterans Affairs appropriations and its delivery of benefits and services to veterans, their dependents and survivors: H.Res. 535, H.Res. 612, H.Res. 674, H.Res. 720, H.Res. 740 H.J. Res. 33, HR 1001, HR 1003, HR 104, HR 1078, HR 1083, HR 1089, HR 1097, HR 1139, HR 1144, HR 1166, HR 1169, HR 1179, HR 1182, HR 1188, HR 1191, HR 1226, HR 1266, HR 1277, HR 1278, HR 1282, HR 1311, HR 1315, HR 1329, HR 1378, HR 1402, HR 1529, HR 1530, HR 1554, HR 1606, HR 1609, HR 1616, HR 1639, HR 1655, HR 1659, HR 1669, HR 1708, HR 1753, HR 1767, HR 1774, HR 1786, HR 1799, HR 1815, HR 1822, HR 1948, HR 1950, HR 196, HR 226, HR 228, HR 232, HR 234, HR 236, HR 2398, HR 2410, HR 2413, HR 2414, HR 2431, HR 2441, HR 2469, HR 2472, HR 2499, HR 251, HR 2518, HR 2525, HR 2526, HR 2543, HR 2733, HR 2768, HR 2809, HR 2828, HR 2830, HR 2846, HR 2896, HR 2932, HR 2971, HR 3023, HR 303, HR 3040, HR 3084, HR 3110, HR 3128, HR 3157, HR 3186, HR 3192, HR 3214, HR 3225, HR 3303, HR 3326, HR 333, HR 3363, HR 3368, HR 3450, HR 3489, HR 3499, HR 3504, HR 3511, HR 3581, HR 3584, HR 3600, HR 3601, HR 3644, HR 3648, HR 3649, HR 3651, HR 3676, HR 3677, HR 3698, HR 3718, HR 3720, HR 3722, HR 3751, HR 3790, HR 3811, HR 3848, HR 3870, HR 3895, HR 394, HR 395, HR 4047, HR 41, HR 411, HR 4150, HR 4157, HR 4249, HR 4262, R 4325, HR 4566, HR 4569, HR 4634, HR 4670, HR 4886, HR 4906, HR 491, HR 492, HR 4921, HR 4944, HR 5002, HR 5014, HR 5147, HR 5153, HR 516, HR 5197, HR 522, HR 523, HR 5247, HR 5259, HR 5287, HR 5365, HR 5367, HR 5377, HR 5416, HR 542, HR 5425, HR 543, HR 544, HR 5470, HR 5492, HR 5530, HR 5559, HR 5610, HR 5633, HR 5682, HR 5697, HR 5702, HR 5794, HR 5860, HR 5870, HR 5904, HR 592, HR 602, HR 608, HR 626, HR 645, HR 693, HR 716, HR 728, HR 733, HR 746, HR 754, HR 768, HR 808, HR 815, HR 854, HR 885, HR 894, HR 903, HR 984, S 10, S 1028, S 1037, S 1040, S 106, S 1090, S 1096, S 1100, S 1119, S 1125, S 1172, S 1266, S 1309, S 1314, S 132, S 1330, S 1360, S 141, S 1436, S 1469, S 1515, S 1590, S 1612, S 1635, S 1678, S 1792, S 1828, S 185, S 1951, S 1954, S 1975, S 1994, S 2014, S 2026, S 216, S 2294, S 2315, S 2386, S 24, S 2422, S 2431, S 2465, S 2503, S 2513, S 2516, S 263, S 2679, S 2718, S 2720, S 2745, S 2757, S 2778, S 2795, S 280, S 2801, S 2803, S 2854, S 2863, S 2873, S 291, S 296, S 2975, S 30, S 302, S 326, S 330, S 344, S 350, S 38, S 414, S 42, S 449, S 495, S 498, S 528, S 531, S 547, S 592, S 596, S 609, S 622, S 633, S 656, S 665, S 680, S 725, S 740, S 748, S 774, S 777, S 853, S 897, S 928, S.J. Res. 17, S.Res. 208, S.Res. 264, S.Res. 335, S.Res. 348, S. Res. 365, S. Res. 405

Client expense: $181,319 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), U.S. Postal Service (USPS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service